A study of the changes in the cause of peptic ulcer bleeding

Fujinami, Haruka; Kudo, Takahiko; Hosokawsa, Ayumu; Ogawa, Kohei; Miyazaki, Tatsuya; Nishikawa, Jun; Kajiura, Shinya; Ando, Takayuki; Ueda, Akira; Sugiyama, Toshiro

doi:10.4253/wjge.v4.i7.323

Cited by 9 publications

(12 citation statements)

References 32 publications

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“…In last decade, usage of non-steroidal anti-inflamatory drugs (NSAID) also increased, especially in the increasing elderly population (16,17). The use of NSAIDs is associated with an increased risk of bleeding ulcers (18,19). In Turkey, life expectancy is also increasing by time.…”

Section: Original Articlementioning

confidence: 99%

Peptic ulcer complications requiring surgery: What has changed in the last 50 years in Turkey

Güzel

Kahramanca²,

Seker³

et al. 2014

Turk J Gastroenterol

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Background/Aims: The incidence and prevalence of peptic ulcer disease has decreased in recent years, but it is not so easy to make the same conclusion when complications of peptic ulcer are taken into consideration. The aim of this study is to determine the time trends in complicated peptic ulcer disease and to state the effects of H2 receptor blockers, proton pump inhibitors (PPI), and H. pylori eradication therapies on these complications. Materials and Methods: This study retrospectively evaluated the patients who were operated on for complications (perforation, bleeding, and obstruction) of peptic ulcer for the last 50 years. Patients were grouped into four groups (G1-G4) according to the dates in which H2 receptor blockers, PPIs, and eradication regimens for H. pylori were introduced The time periods that were studied were: (G1) 1962-1980, (G2) 1981-1990, (G3) 1991-1997, and (G4) 1998-2012. Results: In total, 2953 patients were operated on for complications of peptic ulcer disease, of which 86% of the patients were male. In G1, perforation and obstruction were significantly the most frequent complications (p<0.001), followed by bleeding. In groups G2 and G3, obstruction was still the most frequent complication requiring surgery (p<0.001). In G2 and G3, obstruction was followed by perforation and bleeding, respectively. In G4, perforation was significantly the most frequent complication (p<0.001). Conclusion: From 1962 to 1990 obstruction was the most common complication requiring surgery. In the last decade, perforation became the most common complication. In contrast to reports in the literature, bleeding was the least common complication requiring surgery in Turkey.

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Section: Original Articlementioning

confidence: 99%

Peptic ulcer complications requiring surgery: What has changed in the last 50 years in Turkey

Güzel

Kahramanca²,

Seker³

et al. 2014

Turk J Gastroenterol

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“…It has been demonstrated that Helicobacter pylori infection and the use of nonsteroidal anti-inflammatory drugs (NSAIDs) are the main causes of peptic ulcers [1,2]. In a study from Spain in 2004, H. pylori infection was recognized in 87% of patients with gastric ulcers and 96% of patients with duodenal ulcers [3].…”

Section: Introductionmentioning

confidence: 99%

“…Accordingly, the incidence of peptic ulcer has also decreased both in Western countries [5,6] and in Japan [4]. By contrast, the use of NSAIDs and antithrombotic agents has recently been rising because of the increase in the elderly population [1]. The use of NSAIDs is associated with an increased risk of major upper gastrointestinal complications, including bleeding and perforation [7].…”

Section: Introductionmentioning

confidence: 99%

“…In a study from Spain in 2004, H. pylori infection was recognized in 87% of patients with gastric ulcers and 96% of patients with duodenal ulcers [3]. In recent years, however, the prevalence of H. pylori infection has been decreasing due to the improvement in hygienic conditions and widespread adoption of eradication therapy [1,4]. Accordingly, the incidence of peptic ulcer has also decreased both in Western countries [5,6] and in Japan [4].…”

Section: Introductionmentioning

confidence: 99%

“…H. pylori infection and NSAID use are also considered to be the two major causes of PUB [1,9]. However, there are limited data regarding the chronological changes of the prevalence of H. pylori infection and concomitant use of NSAIDs and antithrombotic agents in patients with PUB [1,10,11]. In the present study, we retrospectively analyze the time trends of H. pylori infection and concomitant use of NSAIDs and antithrombotic agents in Japanese patients with PUB.…”

Section: Introductionmentioning

confidence: 99%

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Time Trends of the Impact of <b><i>Helicobacter pylori</i></b> Infection and Nonsteroidal Anti-Inflammatory Drugs on Peptic Ulcer Bleeding in Japanese Patients

Nagasue¹,

Nakamura²,

Kochi³

et al. 2015

Digestion

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Background/Aims:Helicobacter pylori infection and the use of nonsteroidal anti-inflammatory drugs (NSAIDs) are the main causes of peptic ulcers. The purpose of the present study was to elucidate the time trends of the impact of H. pylori infection and use of NSAIDs and/or antithrombotic agents on peptic ulcer bleeding (PUB) in Japanese patients. Methods: We retrospectively reviewed 719 patients who had received endoscopic hemostasis for PUB between 2002 and 2013. Subjects were divided into either the first-half group (2002-2007, n = 363) or the second-half group (2008-2013, n = 356). The clinical characteristics of the patients, including the prevalence of H. pylori infection and use of NSAIDs and antithrombotic agents, were compared between the two groups. Results: Compared to the first-half group, patients in the second-half group were characterized by older age (proportion of the patients above 60 years old, 63.9 vs. 76.7%, p = 0.0002), less frequent H. pylori infection (71.6 vs. 57.9%, p < 0.001) and more frequent NSAID intake (39.9 vs. 48.6%, p = 0.02). No significant difference was observed regarding the use of antithrombotic agents between the two groups (18.6 vs. 23.3%, p = 0.13). The prevalence of H. pylori infection and proportion of patients above 60 years old were significantly different between the two groups in a multivariate analysis. Conclusion: The main cause of PUB has clearly shifted from H. pylori infection to the use of NSAIDs over the last decade.

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